Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | C029653 | CA |
NPI | 1073588281 |
---|---|
Provider Name | Dr. Judson Schoendorf |
First Address | Long Beach, CA 90806-2329 |
Second Address | Long Beach, CA 90806-2329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 05/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A33987 | (02) |